title: Serum β-d-glucan of critically ill patients with suspected ventilator-associated pneumonia: preliminary observations.
abstract: BACKGROUND
  The purpose of this pilot study was to determine whether β-d-glucan (BG) was associated with Candida in the lung and risk of death in patients with suspected ventilator-associated pneumonia (VAP).
  
  
  METHODS
  In a single-center observational study, we enrolled eligible adults within 24 hours of intensive care unit admission. Patients who developed suspected VAP were divided into 3 groups according to culture results. Serum BG levels and clinical outcomes were collected.
  
  
  RESULTS
  Fifty-seven patients were included; 26 had no growth, 19 patients grew pathogenic bacteria only, and 12 patients grew only Candida. The proportion of patients with a positive BG tended to be greater in the Candida group (66.7% vs 26.3% in bacteria group vs 50.0% in culture-negative group, P = .09). The BG-positive patients were much more likely to die by day 28 than the BG-negative patients (odds ratio, 4.2; 95% confidence limits, 1.1-15.7; P = .03). Patients with both BG positivity and Candida in their lung secretions were much more likely to die compared with patients who did not.
  
  
  CONCLUSIONS
  β-d-Glucan positivity in patients with a suspected VAP may be a marker for Candida in the lung and worse outcomes. Further validation of this postulate is warranted.
authors.affiliation: Department of Medicine, Queen's University, Kingston, ON, Canada; Critical Care, Queen's University, Kingston, ON, Canada; Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada K7L 2V7. Electronic address: dkh2@queensu.ca.
authors.forename: Daren
authors.initials: D
authors.lastname: Heyland
authors.affiliation: Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada K7L 2V7.
authors.forename: Xuran
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada K7L 2V7.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Day
authors.affiliation: Department of Microbiology-Infectious Diseases Hopital Maisonneuve-Rosemont, Montreal, QC, Canada H1T 2M4.
authors.forename: Michel
authors.initials: M
authors.lastname: Laverdiere
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002175:Candida / Q000302:isolation & purification*; D002177:Candidiasis / Q000175:diagnosis* / Q000401:mortality; D016638:Critical Illness; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008168:Lung / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D010865:Pilot Projects; D053717:Pneumonia, Ventilator-Associated / Q000097:blood* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D047071:beta-Glucans / Q000097:blood*
chemical_list: D015415:Biomarkers; D047071:beta-Glucans